Laparoscopic surgeries face a question mark

According to laparoscopic experts, in a hysterectomy surgery, 1.5 to 2 per cent complication rate has been recognised all over the world. The Karnataka Medical Council (KMC) has received six cases of medical negligence related to laparoscopic surgeries in the City lately, wherein three patients died after developing complications during and after surgery.

A 33-year-old woman suffering from tubo-ovarian cyst underwent laparoscopic surgery in a super specialty hospital. The surgeon operating on her accidentally cut her pelvis and large intestine uterine blood vessel which led to excessive bleeding. The patient died.

In another case, a 50-year-old woman underwent laparoscopy for perforated duodenal ulcer. She developed septicemia and other complications and died of infection.

A 26-year-old bus conductor underwent minimal invasive surgery for hernia. He developed peritonitis, ulcer and septic shock. Despite undergoing an open surgery, the patient developed perforated small intestine and eventually died.

Among the patients who survived was a 36-year-old woman, who underwent laparoscopic removal of a right-sided tubo ovarian cyst where the surgeon had accidentally punctured the large intestine which later developed into peritonitis septicemia. She, however, recovered after undergoing treatment in another hospital.  

A 50-year-old woman underwent laparoscopic assisted vaginal hysterectomy and developed urethrovaginal fistulae. The complication was corrected after the patient underwent another surgery in a different hospital, shelling out extra bucks.

Accidentally dissected

A woman suffering from ectopic pregnancy underwent surgery where the laparoscopic surgeon accidentally dissected the fallopian tube. The woman's husband has filed a case in KMC, complaining that his wife will not be able to conceive in the future.

Dr K Ramdev, retired professor and head of surgery at Kempegowda Institute of Medical Science (KIMS), says the assistant surgeon in the operation theatre must be as competent as the surgeon performing the laparoscopic surgery. “Recognising the complication and taking early intervention to treat the complication is important. The team of surgeons must be alert and be prepared for a conversion to conduct an open surgery immediately," he said.

Dr Chikkananjappa, KMC President, says that when a doctor diagnoses the patient, he must make a choice between laparoscopic and normal surgery.

“The competence of the doctor is the most important aspect and the surgeon's expertise in conducting laparoscopy should be verified. The surgeon should invariably educate his patient about the possible complications pre- and post-operation," he said.

Hospitals usually charge more for a laparoscopic surgery, claiming that it involves minimal loss of blood, shorter stay in the hospital and quick recovery. With young laparoscopic surgeons mushrooming across the City, KMC will be coming up with guidelines to check the expertise of doctors. The surgeon's experience in performing such surgeries will be verified.


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